Endothelial dysfunction, inflammation, and oxidative stress in obese children and adolescents: markers and effect of lifestyle intervention

Abstract

With an increasing prevalence, pediatric obesity is often a prelude to adulthood obesity, and represents a major public health issue. Comorbidities are very common and severe in obese adults, justifying the search for earlier markers or risk factors for cardiovascular diseases in obese children. Endothelial dysfunction has been found to be present in the early stages of atherosclerosis, and can be non-invasively assessed with widely accepted and well-standardized techniques at the macrocirculation level. Endothelial dysfunction at the microcirculation level is less documented in obese children. Obesity in children has been repeatedly and independently correlated to endothelial dysfunction, inflammation and oxidative stress markers, although the relationship between these factors remains to be investigated. However, this would not only allow substantial improvements in risk stratification, but also provide essential data regarding the evolution of endothelial dysfunction in childhood obesity, especially during puberty when pro-inflammatory and pro-oxidative changes, with relative insulin resistance, occur. Therapeutic strategies such as lifestyle interventions in early childhood obesity appear all the more necessary, optimally including both exercise and diet because of their known effects on inflammatory and oxidative stress markers, potentially reversing endothelial dysfunction.

Diet, Exercise, and Endothelial Function in Obese Adolescents

“…By applying these techniques, it was demonstrated that the flow-associated dilatory capacity of the endothelium in obese adolescents is reduced both at the macrovascular 2 and microvascular level. 3 Moreover, microvascular endothelial dysfunction appears to precede macrovascular endothelial dysfunction, 4 indicating that these manifestations reflect various early stages of vascular disease. Endothelial function is negatively affected by both traditional cardiovascular risk factors, such as hypertension and sedentary lifestyle, and novel cardiovascular risk factors, including inflammatory (eg, high C-reactive protein) and antiinflammatory markers (eg, low adiponectin).…”

“…21 Fixated whole blood was lysed using NH 4 Cl, centrifuged and supernatant was decanted. FcR blocking reagent (Miltenyi Biotec, Bergisch Gladbach, Germany) was added to the pellet as well as the following antibodies: 17.5 mL anti-CD3 PerCP, 10 mL anti-KDR APC, 7.5 mL anti-CD34 phycoerythrin Cy7 and 5 mL anti-CD45 APC H7 (BD Biosciences, except anti-KDR APC, which was from R&D Systems).…”

Childhood obesity–related endothelial dysfunction: an update on pathophysiological mechanisms and diagnostic advancements

“…Endothelial dysfunction was demonstrated in the major conduit arteries of obese children and is referred to as macrovascular endothelial dysfunction (10). Although endothelial dysfunction is considered a "systemic disorder, " dysfunction of small resistance vessels, microvascular endothelial dysfunction, precedes the development of macrovascular endothelial dysfunction (11).…”

Correlation between adipokines and carotid intima media thickness in a group of obese Romanian children: is small for gestational age status an independent factor for cardiovascular risk?

“…Several studies showed that hsCRP is a strong independent predictor of cardiovascular risk. It has a role at different phases of atherosclerosis (17). Adults with hsCRP above 0.3 mg/dL have twice the risk of atherosclerosis compared to those with low levels (< 0.1 mg/dL) (18,19).…”